This is a guide to the remuneration of occupational physicians working outside the NHS. It’s aimed at:
- doctors who work as occupational physicians
- employers of occupational physicians, either as employees or as self-employed contractors
- organisations that provide occupational health services
See our guidance on the duties and qualifications of occupational physicians.
The BMA view
We believe that, as a minimum, doctors working as occupational physicians outside the NHS should earn a comparable amount to doctors who work in the NHS.
This guidance considers the seniority and responsibilities of occupational physicians in relation to their NHS counterparts – from specialty registrars to consultants with clinical excellence awards.
Pay ranges in the NHS
Below is the range of salaries for full-time hospital doctors in the NHS in England. Occupational physicians and employers may find it useful to refer to this in negotiations.
The table shows the seniority of occupational physician that we believe equates to the NHS grades. In negotiating a salary, the doctor’s experience, qualifications, length of service and responsibilities should be taken into account, as well as the terms and conditions of their contract.
If a doctor is employed on a part-time or sessional basis, pay and entitlement to benefits should be pro rata to these whole-time salaries and benefits.
|Specialty registrar||Trainee occupational physician||£36,461 to £46,208|
Progress through this range should normally take no more than five years. It applies to a doctor who enters specialist training directly after completing basic medical training. A higher rate may be appropriate for doctors with other qualifications or relevant experience.
|Consultant, initial appointment||Occupational physician||£76,761 to £86,369|
Progress through this range should normally take no more than five years depending on experience, qualifications and responsibilities. In the NHS it is possible for a consultant in this band with additional responsibilities, or who demonstrates a significant contribution to the specialty, to earn up to £102,466.
|Experienced consultant||Senior occupational physician||£86,369 to £139,682|
Progress through the salary range should normally take no more than 10 years. An experienced NHS consultant in a senior position with additional responsibilities, or who demonstrates a significant contribution to the specialty, can earn up to £178,004 (with clinical excellence awards).
We also recommend taking into account additional expenses caused by rises in the consumer price index, and that any pay award is in line with senior managers.
Terms and conditions of service
As with salaries, we believe non-NHS employers should at least match the terms and conditions of service for NHS doctors.
- Hours of work: 40 hours per week
- Holiday entitlement: six weeks per annum plus statutory holidays; consultants with seven or more years of service receive an extra two days’ leave
- Study leave and continuing professional development: recommended levels are up to 30 paid days a year for specialty registrars, and 30 paid days over three years for consultants. The cost of courses should be reimbursed
- Medical indemnity: NHS doctors are indemnified for their NHS work but must arrange insurance for other work
- London weighting: £2,162 a year
- NHS pension scheme: Normal pension age linked to state pension age. Career average revalued earnings index-linked scheme. Pension calculated as 1/54th of actual revalued earnings for each year of service. Earnings are revalued by CPI+1.5%. No automatic lump sum entitlement, but there is the option to receive a tax-free lump sum up to HMRC limits by giving up part of the pension. The employer contribution is 14.38% of salary, and employees pay tiered contributions dependent on their full-time equivalent earnings. For earnings over £111,377 the top tier of contributions is 14.5%.
The NHS pension scheme includes 2015, 2008 and 1995 sections, with varying pension ages and varying calculations for reckonable pay.
The above salaries do not include an allowance for out-of-hours or standby duties that the doctor may need to perform.
In the NHS, the allowance for specialty registrars ranges from 20% to 100% of basic salary, depending on how onerous the duties are. For consultants, additional payments range from 1% to 8% of basic full-time salary.
A growing number of specialist occupational physicians are self-employed practitioners with a portfolio of clients, contracting separately with each one.
It is important that both the doctor and employer realise the fees charged should reflect both the loss of benefits that are given to employees – such as sickness and holiday provision – and the overhead costs of running a business. Costs include:
- contributions by an employer to a pension scheme
- National Insurance
- revalidation and continuous professional development
- professional indemnity insurance
- provision of support staff
- provision of supplies and equipment premises.
We can’t say how much needs to be included in fees to allow for these costs, as circumstances vary widely. However, for a self-employed doctor to earn an equal amount to the NHS salaries listed above, their fees should be higher.
It is reasonable to expect your income, after allowing for the loss of benefits and additional costs, to compare to that of a similarly experienced occupational physician who works as an employee.
Many commercial organisations contract to provide occupational health advice and support. This may include the services of doctors who hold a range of qualifications.
Their charges will depend on negotiations between those concerned, and the information above may be useful in determining pay scales.